Paramedic Exam Study Prep - Airway and Breathing

Paramedic Exam Study Prep - Airway and Breathing A child in respiratory distress may grunt as the child breathes. This is a result of (A) increase tidal volume. (B) an increased respiratory rate. (C) creating pressure to help maintain open airways. (D) an indication that the child is tired and will progress to respiratory arrest. C. Grunting involves exhaling against a partially closed glottis. This creates pressure to help maintain open lower airways similar to pursed-lip breathing in adults with COPD. This short low-pitched sound is often mistaken for whimpering and suggests severe hypoxia. Respiratory acidosis is caused by (A) an excess of bicarbonate. (B) excess carbon dioxide retention. (C) a loss of bicarbonate. (D) excess carbon dioxide excretion. B. Respiratory acidosis is caused by excess carbon dioxide retention. Scenario: You are using an end-tidal carbon dioxide detector as a tool to assist for proper endotracheal intubation placement. Question: The absence of carbon dioxide in exhaled air indicates the endotracheal tube has been (A) placed in the right mainstem bronchus. (B) correctly placed in the trachea. (C) placed in the esophagus. (D) placed in the left mainstem bronchus. C. The absence of carbon dioxide likely indicates that the endotracheal tube has been placed in the esophagus. Verifying correct endotracheal tube placement is absolutely essential. ETCO2 is only one method to assist in verification. Scenario: You are using an end-tidal carbon dioxide detector as a tool to assist for proper endotracheal intubation placement. Question: Your next action is to (A) deflate the cuff, pull the endotracheal tube back 2 cm, and reassess placement. (B) secure the endotracheal tube and confirm correct placement by auscultation. (C) inflate the distal cuff with 7-10 cc of air and secure the endotracheal tube. (D) remove the endotracheal tube and provide several ventilations prior to attempting intubation again. D. The endotracheal tube is likely placed in the esophagus. Your next action is to remove the endotracheal tube and provide several ventilations with supplemental oxygen prior to attempting another intubation. Which of the following drugs is used for rapid sequence intubation? (A) Vecuronium (B) Succinylcholine (C) Lidocaine and atropine (D) All of the above D. All of the above. Vecuronium is a common nondepolarizing neuromuscular blocker. Lidocaine is commonly used in RSI to prevent dysrhythmias associated with stimulation of the glottis associated with intubation. Atropine is often administered to decrease the incidence of bradycardia associated with the administration of succinylcholine. You are called for a 54-year-old woman who is unconscious. Your assessment reveals the patient to be apneic and pulseless. Initial management of this patient's airway should include (A) assisted ventilation with a bag-valve device at 6-10 LPM. (B) assisted ventilation with a nonrebreather mask at 10-15 LPM. (C)immediate nasotracheal intubation and ventilation with a bag-valve device. (D) insertion of an oropharyngeal airway and ventilation with a bag-valve device. D. Of the choice listed, insertion of an oropharyngeal airway and ventilating with a bag-valve device is the best answer. (A). is incorrect because it utilizes a nonrebreather mask to assist ventilations. nonrebreather are not designed for or capable of assisting ventilations. (C). is incorrect because an apneic patient cannot be nasotracheally intubated. The Esophageal Tracheal Combitube (ETCT) and the pharyngotracheal lumen airway (PTL) are similar because (A) neither requires assessment for accurate placement. (B)both require manipulation of the head and neck for insertion. (C)neither is inserted blindly. (D) None of the above. D. None of the above are correct. (A). is in correct because both devices require assessment for accurate placement. With the PTL you begin ventilation though a short tube (the one without the stylet); with the Combitube, you begin ventilation through a longer blue tube. If chest rise and presence of breath sounds are not observe, you must switch immediately to the other ventilation port and reassess. (B). is incorrect because both are inserted in the neutral position and no manipulation of the head and neck is required for insertion. (C). is incorrect because both devices are inserted blindly.